Ciprofloxacin hydrochloride

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[sip-row-FLOX-ah-sin] Pregnancy Category: C

Ciloxan Ophthalmic, Cipro, Cipro Cystitis Pack, Cipro I.V. (Rx) Classification: Fluoroquinolone anti-infective

See also Fluoroquinolones. Action/Kinetics: Effective against both gram-positive and gram-negative organisms. Rapidly and well absorbed following PO administration. Food delays absorption of the drug. Maximum serum levels: 2—4 mcg/mL 1—2 hr after dosing. tV2: 4 hr for PO use and 5—6 hr for IV use. Avoid peak serum levels above 5 mcg/mL. About 40%-50% of a PO dose and 50%-70% of an IV dose is excreted unchanged in the urine. Uses: Systemic. UTIs caused by Escherichia coli, Enterobacter cloacae, Citrobacter diversus, Citrobacter freundii, Klebsiella pneumoniae, Proteus mirabilis, Providencia rett-geri, Pseudomonas aeruginosa, Morganella morganii, Serratia marces-cens, Serratia epidermidis, and Streptococcus faecalis. Uncomplicated cervical and urethral gonorrhea due to Neisseria gonorrhoeae. Chancroid due to Haemophilus ducreyi; un-

complicated or disseminated gono-coccal infections.

Mild to moderate chronic bacterial prostatitis due to E. eoli or P. mirabilis.

Mild to moderate sinusitis due to S. pneumoniae, H. influenzae, or M. eatarrhalis.

Lower respiratory tract infections caused by E. eoli, E. eloaeae, K. pneumoniae, P. mirabilis, P. aerugi-nosa, Haemophilus influenzae, H. parainfluenzae, and Streptococcus pneumoniae.

Bone and joint infections due to E. eloaeae, P. aeruginosa, and S. mareeseens.

Skin and skin structure infections caused by E. eoli, E. eloaeae, Citrobacter freundii, M. morganii, K. pneumoniae, P. aeruginosa, P. mirabilis, Proteus vulgaris, Provideneia stuartii, Staphyloeoeeus pyogenes, Staphyloeoeeus epidermidis, and penicillinase- and non-penicillinase-producing strains of Staphyloeoeeus aureus.

Infectious diarrhea caused by enter-otoxigenic strains of E. eoli. Also, Campylobacter jejuni, Shigella flex-neri, and Shigella sonnei.

Typhoid fever (enteric fever) due to Salmonella typhi. Efficacy in eradicating the chronic typhoid carrier state has not been shown.

IV as empirical therapy in febrile neutropenia.

Non-FDA Approved Uses: Clients, over 14 years of age, with cystic fibro-sis who have pulmonary exacerbations due to susceptible microorganisms. Malignant external otitis. In combination with rifampin and other tuberculostatics for tuberculosis.

Ophthalmic. Superficial ocular infections due to Staphyloeoeeus species (including S. aureus), Strepto-eoeeus species (including S. pneu-moniae, S. pyogenes), E. eoli, H. ducreyi, H. influenzae, H. para-influenzae, K. pneumoniae, N. go-norrhoeae, Proteus species, Klebsiel-la species, Aeinetobaeter ealeoaeeti-eus, Enterobaeter aerogenes, P. ae-

ruginosa, S. marcescens, Chlamydia trachomatis, Vibrio species, and Providencia species. Contraindications: Hypersensitivity to quinolones. Use in children. Lactation. Ophthalmic use in the presence of dendritic keratitis, varicella, vaccinia, and mycobacterial and fungal eye infections and after removal of foreign bodies from the cornea.

Special Concerns: Safety and effectiveness of ophthalmic, PO, or IV use have not been determined in children.

Additional Side Effects: See also Side Effects for Fluoroquinolones. Oral: Dry, painful mouth, oral candidiasis. GI: N&V, abdominal pain/discomfort, diarrhea, dry/painful mouth, dyspepsia, heartburn, constipation, flatulence, pseudomembra-nous colitis, oral candidiasis, intestinal perforation, anorexia, GI bleeding, bad taste in mouth. CNS: Headache, dizziness, fatigue, lethargy, malaise, drowsiness, restlessness, insomnia, nightmares, hallucinations, tremor, lightheadedness, irritability, confusion, ataxia, mania, weakness, psychotic reactions, depression, deper-sonalization, seizures. GU: Nephritis, hematuria, cylindruria, renal failure, urinary retention, polyuria, vaginitis, urethral bleeding, acidosis, renal calculi, interstitial nephritis, vaginal candidiasis. Skin: Urticaria, photo-sensitivity, hypersensitivity, flushing, erythema nodosum, cutaneous candi-diasis, hyperpigmentation, rash, pares-thesia, edema (of lips, neck, face, conjunctivae, hands), angioedema, toxic epidermal necrolysis, exfolia-tive dermatitis, Stevens-Johnson syndrome. Ophthalmic: Blurred or disturbed vision, double vision, eye pain, nystagmus. CV: Hypertension, syncope, angina pectoris, palpitations, atrial flutter, MI, cerebral thrombosis, ventricular ectopy, cardi-opulmonary arrest, postural hypotension. Respiratory: Dyspnea, broncho-spasm, pulmonary embolism, edema of larynx or lungs, hemoptysis, hic coughs, epistaxis. Hematologic: Eosin-ophilia, pancytopenia, leukopenia, anemia, leukocytosis, agranulocytosis, bleeding diathesis. Miscellane-

■ ous: Superinfections; fever; chills; tinnitus; joint pain or stiffness; back, neck, or chest pain; flare-up of gout; flushing; worsening of myasthenia gravis; hepatic necrosis; cholestatic jaundice; hearing loss, dysphasia.

After ophthalmic use: Irritation, burning, itching, angioneurotic edema, urticaria, maculopapular and vesicular dermatitis, crusting of lid margins, conjunctival hyperemia, bad taste in mouth, corneal staining, keratitis, keratopathy, allergic reactions, photophobia, decreased vision, tearing, lid edema. Also, a white, crystalline precipitate in the superficial part of corneal defect (onset within 1—7 days after initiating therapy; lasts about 2 weeks and does not affect continued use of the medication).

How Supplied: Injection: 10 mg/mL, 200 mg/100 mL, 400 mg/200 mL; Ophthalmic solution: 0.3%; Tablet: 100 mg, 250 mg, 500 mg, 750 mg


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